Purpose Medical students receive a varying amount of training in medical ethics and are expected to navigate clinical ethical dilemmas innately. There is little literature on attempts to navigate ethical dilemmas experienced during early clinical experiences and whether current curricula prepare students for these dilemmas. This study explores the different ethical dilemmas experienced by medical students on their third-year clerkships and analyzes the factors, sources, and resolutions proposed by them.Methods From 2016 to 2018, third-year medical students completed a written assignment (...) to describe, analyze, and reflect on a clinical situation in which they experienced an ethical dilemma. They identified specific ethical dilemmas present, potential preventative and aftermath solutions, and reflected on their professional development from their experience. The research team utilized applied thematic analysis to identify themes and patterns in the data. A thematic matrix was utilized to examine similarities and differences across medical students.Results Of the 162 reflections, 144 (88.9%) students indicated an ethical dilemma that included issues related to autonomy and beneficence. Of these, 116 (71.6%) students found the two ethical principles in direct conflict. Students identified three common sources of this conflict: lack of communication; unclear understanding of clinical policies regarding family authority and psychiatric capacity; and medical negligence. Lastly, students suggested different solutions for dealing with and preventing this conflict.Conclusion Our findings suggest that an overwhelming number of students face ethical challenges when confronted with medical situations that raise conflicts between autonomy and beneficence. Their recommended solutions reveal an appeal among students to have tools and strategies in place to ease the need to make difficult decisions. Medical students might be better served by learning about the complexities of ethical decision-making and the likelihood of experiencing moral distress when they feel an inability to implement what they envision as the best solution. (shrink)

While rooted in careful study of Mead’s original writings and transcribed lectures and the historical context in which that work was carried out, the papers in this volume have brought Mead’s work to bear on contemporary issues in metaphysics, epistemology, cognitive science, and social and political philosophy.

Philosophical Pragmatism and International Relations bridges the gap between philosophical pragmatism and international relations, two disciplinary perspectives that together shed light on how to advance the study and conduct of foreign affairs. Authors in this collection discuss a broad range of issues, from policy relevance to peacekeeping operations, with an eye to understanding how this distinctly American philosophy, pragmatism, can improve both international relations research and foreign policy practice.

The use of the temporal augment in narrative we have found to be purely scansional. Scansional, too, is the use of the syllabic, though this has a grammatical restriction which is of some interest; indeed, next to the maintenance of type öρovδΕ, it is the most vital fact for the whole question. The unaugmented aorist is not felt as an inflection which has been docked of its first syllable; quite the reverse, the augmented tense is treated as a compound. For (...) example, é normally stands second in its clause; and so, if the syllabic augment was still consciously regarded as what it really is—viz. an adverb in composition—we should expect to see a great unwillingness to place Be after a tense thus augmented. Our expectation is fully borne out by the text; in the whole narrative of the Iliad there are only sixteen sure examples of é standing after the syllabically augmented aorist. (shrink)

Regulated secretory proteins are stored within specialized vesicles known as secretory granules. It is not known how proteins are sorted into these organelles. Regulated proteins may possess targeting signals which interact with specific sorting receptors in the lumen of the trans‐Golgi network (TGN) prior to their aggregation to form the characteristic dense‐core of the granule. Alternatively, sorting may occur as the result of specific aggregation of regulated proteins in the TGN. Aggregates may be directed to secretory granules by interaction of (...) a targeting signal on the surface with a sorting receptor. Novel targeting signals which confer on regulated proteins a tendency to aggregate under certain conditions, and in so doing cause them to be incorporated into secretory granules, have been implicated. Specific targeting signals may also play a role in directing membrane proteins to secretory granules. (shrink)

Schwinger’s algebra of microscopic measurement, with the associated complex field of transformation functions, is shown to provide the foundation for a discrete quantum phase space of known type, equipped with a Wigner function and a star product. Discrete position and momentum variables label points in the phase space, each taking \(N\) distinct values, where \(N\) is any chosen prime number. Because of the direct physical interpretation of the measurement symbols, the phase space structure is thereby related to definite experimental configurations.